PURPOSE: The purpose of this study is to use data from the 1987 National Medical Expenditure Survey (NMES) to evaluate African and Hispanic Americans; reliance on a regular provider or hospital based ambulatory care for their medical care. OBJECTIVE: The specific objectives are to determine whether African and Hispanic Americans report a lower proportion of their ambulatory visits to a regular provider, and if so they substitute this care with care delivered in a hospital outpatient clinic or emergency room. RATIONALE: Approximately 37 million Americans are without coverage. Yet in spite of the conclusion that African and Hispanic Americans make up a disproportionate amount of the growing population of uninsured Americans, several researchers have concluded that African and Hispanic Americans have achieved equity of access to medical care. What remains unclear is whether this "equity of access" represents access to quantity as opposed to the quality of medical services. In particular, it has been suspected that African and Hispanic Americans receive less continuous care (because of their use of hospital based ambulatory care and persistent differences in health status). If this is true, efforts to expand health coverage without assessing the organization of care could lead to the perpetuation of a two-tiered system of care. DESIGN AND METHODS: The 1987 NMES was a national, randomized survey of approximately 15,000 household with 36,400 individuals. It contains extensive information regarding income, health status, insurance coverage, the usual source of care, medical use and medical expenditures. The survey oversampled African and Hispanic Americans, the poor and the functionally impaired. Measures of the use of ambulatory utilization will be used to measure continuity of care for African and Hispanic Americans. This analysis will involve both descriptive and multivariate comparisons of the care delivered to African and Hispanic Americans. SIGNIFICANCE: The results will draw attention to the need to consider not just whether African and Hispanic Americans gain access to care but whether they are going to similar medical settings as the majority of Americans. As part of the effort to improve the access to care of disadvantaged Americans it may be necessary for us to consider whether new proposals will result in improvements in the organization nd the financing of care.